Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES

Facility

$7,459.80

Service Code	MSDRG 776
Min. Negotiated Rate	$5,669.45
Max. Negotiated Rate	$7,459.80
Rate for Payer: Aetna Medicare	$6,206.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$7,459.80
Rate for Payer: Amish Plain Church Group Commercial	$7,459.80
Rate for Payer: BCBS MAPPO	$5,967.84
Rate for Payer: BCN Medicare Advantage	$5,967.84
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,967.84
Rate for Payer: Mclaren Medicare	$5,967.84
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,266.23
Rate for Payer: MI Amish Medical Board Commercial	$6,863.02
Rate for Payer: PACE Medicare	$5,669.45
Rate for Payer: PACE SWMI	$5,967.84
Rate for Payer: PHP Medicare Advantage	$5,967.84
Rate for Payer: Priority Health Medicare	$5,967.84
Rate for Payer: Railroad Medicare Medicare	$5,967.84
Rate for Payer: UHC Dual Complete DSNP	$5,967.84
Rate for Payer: UHC Medicare Advantage	$5,967.84
Rate for Payer: VA VA	$5,967.84

MS-DRG 42.00: PREMATURITY WITH MAJOR PROBLEMS

Facility

$39,694.68

Service Code	MSDRG 791
Min. Negotiated Rate	$30,167.95
Max. Negotiated Rate	$39,694.68
Rate for Payer: Aetna Medicare	$33,025.97
Rate for Payer: Allen County Amish Medical Aid Commercial	$39,694.68
Rate for Payer: Amish Plain Church Group Commercial	$39,694.68
Rate for Payer: BCBS MAPPO	$31,755.74
Rate for Payer: BCN Medicare Advantage	$31,755.74
Rate for Payer: Health Alliance Plan Medicare Advantage	$31,755.74
Rate for Payer: Mclaren Medicare	$31,755.74
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$33,343.53
Rate for Payer: MI Amish Medical Board Commercial	$36,519.10
Rate for Payer: PACE Medicare	$30,167.95
Rate for Payer: PACE SWMI	$31,755.74
Rate for Payer: PHP Medicare Advantage	$31,755.74
Rate for Payer: Priority Health Medicare	$31,755.74
Rate for Payer: Railroad Medicare Medicare	$31,755.74
Rate for Payer: UHC Dual Complete DSNP	$31,755.74
Rate for Payer: UHC Medicare Advantage	$31,755.74
Rate for Payer: VA VA	$31,755.74

MS-DRG 42.00: PREMATURITY WITHOUT MAJOR PROBLEMS

Facility

$24,184.09

Service Code	MSDRG 792
Min. Negotiated Rate	$18,379.91
Max. Negotiated Rate	$24,184.09
Rate for Payer: Aetna Medicare	$20,121.16
Rate for Payer: Allen County Amish Medical Aid Commercial	$24,184.09
Rate for Payer: Amish Plain Church Group Commercial	$24,184.09
Rate for Payer: BCBS MAPPO	$19,347.27
Rate for Payer: BCN Medicare Advantage	$19,347.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$19,347.27
Rate for Payer: Mclaren Medicare	$19,347.27
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$20,314.63
Rate for Payer: MI Amish Medical Board Commercial	$22,249.36
Rate for Payer: PACE Medicare	$18,379.91
Rate for Payer: PACE SWMI	$19,347.27
Rate for Payer: PHP Medicare Advantage	$19,347.27
Rate for Payer: Priority Health Medicare	$19,347.27
Rate for Payer: Railroad Medicare Medicare	$19,347.27
Rate for Payer: UHC Dual Complete DSNP	$19,347.27
Rate for Payer: UHC Medicare Advantage	$19,347.27
Rate for Payer: VA VA	$19,347.27

MS-DRG 42.00: PROSTATECTOMY WITH CC

Facility

$16,454.80

Service Code	MSDRG 666
Min. Negotiated Rate	$12,505.65
Max. Negotiated Rate	$16,454.80
Rate for Payer: Aetna Medicare	$13,690.39
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,454.80
Rate for Payer: Amish Plain Church Group Commercial	$16,454.80
Rate for Payer: BCBS MAPPO	$13,163.84
Rate for Payer: BCN Medicare Advantage	$13,163.84
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,163.84
Rate for Payer: Mclaren Medicare	$13,163.84
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,822.03
Rate for Payer: MI Amish Medical Board Commercial	$15,138.42
Rate for Payer: PACE Medicare	$12,505.65
Rate for Payer: PACE SWMI	$13,163.84
Rate for Payer: PHP Medicare Advantage	$13,163.84
Rate for Payer: Priority Health Medicare	$13,163.84
Rate for Payer: Railroad Medicare Medicare	$13,163.84
Rate for Payer: UHC Dual Complete DSNP	$13,163.84
Rate for Payer: UHC Medicare Advantage	$13,163.84
Rate for Payer: VA VA	$13,163.84

MS-DRG 42.00: PROSTATECTOMY WITH MCC

Facility

$33,661.69

Service Code	MSDRG 665
Min. Negotiated Rate	$25,582.88
Max. Negotiated Rate	$33,661.69
Rate for Payer: Aetna Medicare	$28,006.52
Rate for Payer: Allen County Amish Medical Aid Commercial	$33,661.69
Rate for Payer: Amish Plain Church Group Commercial	$33,661.69
Rate for Payer: BCBS MAPPO	$26,929.35
Rate for Payer: BCN Medicare Advantage	$26,929.35
Rate for Payer: Health Alliance Plan Medicare Advantage	$26,929.35
Rate for Payer: Mclaren Medicare	$26,929.35
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$28,275.82
Rate for Payer: MI Amish Medical Board Commercial	$30,968.75
Rate for Payer: PACE Medicare	$25,582.88
Rate for Payer: PACE SWMI	$26,929.35
Rate for Payer: PHP Medicare Advantage	$26,929.35
Rate for Payer: Priority Health Medicare	$26,929.35
Rate for Payer: Railroad Medicare Medicare	$26,929.35
Rate for Payer: UHC Dual Complete DSNP	$26,929.35
Rate for Payer: UHC Medicare Advantage	$26,929.35
Rate for Payer: VA VA	$26,929.35

MS-DRG 42.00: PROSTATECTOMY WITHOUT CC/MCC

Facility

$10,487.35

Service Code	MSDRG 667
Min. Negotiated Rate	$7,970.39
Max. Negotiated Rate	$10,487.35
Rate for Payer: Aetna Medicare	$8,725.48
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,487.35
Rate for Payer: Amish Plain Church Group Commercial	$10,487.35
Rate for Payer: BCBS MAPPO	$8,389.88
Rate for Payer: BCN Medicare Advantage	$8,389.88
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,389.88
Rate for Payer: Mclaren Medicare	$8,389.88
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,809.37
Rate for Payer: MI Amish Medical Board Commercial	$9,648.36
Rate for Payer: PACE Medicare	$7,970.39
Rate for Payer: PACE SWMI	$8,389.88
Rate for Payer: PHP Medicare Advantage	$8,389.88
Rate for Payer: Priority Health Medicare	$8,389.88
Rate for Payer: Railroad Medicare Medicare	$8,389.88
Rate for Payer: UHC Dual Complete DSNP	$8,389.88
Rate for Payer: UHC Medicare Advantage	$8,389.88
Rate for Payer: VA VA	$8,389.88

MS-DRG 42.00: PSYCHOSES

Facility

$14,165.14

Service Code	MSDRG 885
Min. Negotiated Rate	$10,765.50
Max. Negotiated Rate	$14,165.14
Rate for Payer: Aetna Medicare	$11,785.39
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,165.14
Rate for Payer: Amish Plain Church Group Commercial	$14,165.14
Rate for Payer: BCBS MAPPO	$11,332.11
Rate for Payer: BCN Medicare Advantage	$11,332.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,332.11
Rate for Payer: Mclaren Medicare	$11,332.11
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,898.72
Rate for Payer: MI Amish Medical Board Commercial	$13,031.93
Rate for Payer: PACE Medicare	$10,765.50
Rate for Payer: PACE SWMI	$11,332.11
Rate for Payer: PHP Medicare Advantage	$11,332.11
Rate for Payer: Priority Health Medicare	$11,332.11
Rate for Payer: Railroad Medicare Medicare	$11,332.11
Rate for Payer: UHC Dual Complete DSNP	$11,332.11
Rate for Payer: UHC Medicare Advantage	$11,332.11
Rate for Payer: VA VA	$11,332.11

MS-DRG 42.00: PULMONARY EDEMA AND RESPIRATORY FAILURE

Facility

$12,506.36

Service Code	MSDRG 189
Min. Negotiated Rate	$9,504.84
Max. Negotiated Rate	$12,506.36
Rate for Payer: Aetna Medicare	$10,405.29
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,506.36
Rate for Payer: Amish Plain Church Group Commercial	$12,506.36
Rate for Payer: BCBS MAPPO	$10,005.09
Rate for Payer: BCN Medicare Advantage	$10,005.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$10,005.09
Rate for Payer: Mclaren Medicare	$10,005.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$10,505.34
Rate for Payer: MI Amish Medical Board Commercial	$11,505.85
Rate for Payer: PACE Medicare	$9,504.84
Rate for Payer: PACE SWMI	$10,005.09
Rate for Payer: PHP Medicare Advantage	$10,005.09
Rate for Payer: Priority Health Medicare	$10,005.09
Rate for Payer: Railroad Medicare Medicare	$10,005.09
Rate for Payer: UHC Dual Complete DSNP	$10,005.09
Rate for Payer: UHC Medicare Advantage	$10,005.09
Rate for Payer: VA VA	$10,005.09

MS-DRG 42.00: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE

Facility

$14,160.29

Service Code	MSDRG 175
Min. Negotiated Rate	$10,761.82
Max. Negotiated Rate	$14,160.29
Rate for Payer: Aetna Medicare	$11,781.36
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,160.29
Rate for Payer: Amish Plain Church Group Commercial	$14,160.29
Rate for Payer: BCBS MAPPO	$11,328.23
Rate for Payer: BCN Medicare Advantage	$11,328.23
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,328.23
Rate for Payer: Mclaren Medicare	$11,328.23
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,894.64
Rate for Payer: MI Amish Medical Board Commercial	$13,027.46
Rate for Payer: PACE Medicare	$10,761.82
Rate for Payer: PACE SWMI	$11,328.23
Rate for Payer: PHP Medicare Advantage	$11,328.23
Rate for Payer: Priority Health Medicare	$11,328.23
Rate for Payer: Railroad Medicare Medicare	$11,328.23
Rate for Payer: UHC Dual Complete DSNP	$11,328.23
Rate for Payer: UHC Medicare Advantage	$11,328.23
Rate for Payer: VA VA	$11,328.23

MS-DRG 42.00: PULMONARY EMBOLISM WITHOUT MCC

Facility

$8,432.69

Service Code	MSDRG 176
Min. Negotiated Rate	$6,408.84
Max. Negotiated Rate	$8,432.69
Rate for Payer: Aetna Medicare	$7,016.00
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,432.69
Rate for Payer: Amish Plain Church Group Commercial	$8,432.69
Rate for Payer: BCBS MAPPO	$6,746.15
Rate for Payer: BCN Medicare Advantage	$6,746.15
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,746.15
Rate for Payer: Mclaren Medicare	$6,746.15
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,083.46
Rate for Payer: MI Amish Medical Board Commercial	$7,758.07
Rate for Payer: PACE Medicare	$6,408.84
Rate for Payer: PACE SWMI	$6,746.15
Rate for Payer: PHP Medicare Advantage	$6,746.15
Rate for Payer: Priority Health Medicare	$6,746.15
Rate for Payer: Railroad Medicare Medicare	$6,746.15
Rate for Payer: UHC Dual Complete DSNP	$6,746.15
Rate for Payer: UHC Medicare Advantage	$6,746.15
Rate for Payer: VA VA	$6,746.15

MS-DRG 42.00: RADIOTHERAPY

Facility

$26,316.76

Service Code	MSDRG 849
Min. Negotiated Rate	$20,000.74
Max. Negotiated Rate	$26,316.76
Rate for Payer: Aetna Medicare	$21,895.55
Rate for Payer: Allen County Amish Medical Aid Commercial	$26,316.76
Rate for Payer: Amish Plain Church Group Commercial	$26,316.76
Rate for Payer: BCBS MAPPO	$21,053.41
Rate for Payer: BCN Medicare Advantage	$21,053.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$21,053.41
Rate for Payer: Mclaren Medicare	$21,053.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$22,106.08
Rate for Payer: MI Amish Medical Board Commercial	$24,211.42
Rate for Payer: PACE Medicare	$20,000.74
Rate for Payer: PACE SWMI	$21,053.41
Rate for Payer: PHP Medicare Advantage	$21,053.41
Rate for Payer: Priority Health Medicare	$21,053.41
Rate for Payer: Railroad Medicare Medicare	$21,053.41
Rate for Payer: UHC Dual Complete DSNP	$21,053.41
Rate for Payer: UHC Medicare Advantage	$21,053.41
Rate for Payer: VA VA	$21,053.41

MS-DRG 42.00: RECTAL RESECTION WITH CC

Facility

$21,059.21

Service Code	MSDRG 333
Min. Negotiated Rate	$16,005.00
Max. Negotiated Rate	$21,059.21
Rate for Payer: Aetna Medicare	$17,521.26
Rate for Payer: Allen County Amish Medical Aid Commercial	$21,059.21
Rate for Payer: Amish Plain Church Group Commercial	$21,059.21
Rate for Payer: BCBS MAPPO	$16,847.37
Rate for Payer: BCN Medicare Advantage	$16,847.37
Rate for Payer: Health Alliance Plan Medicare Advantage	$16,847.37
Rate for Payer: Mclaren Medicare	$16,847.37
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$17,689.74
Rate for Payer: MI Amish Medical Board Commercial	$19,374.48
Rate for Payer: PACE Medicare	$16,005.00
Rate for Payer: PACE SWMI	$16,847.37
Rate for Payer: PHP Medicare Advantage	$16,847.37
Rate for Payer: Priority Health Medicare	$16,847.37
Rate for Payer: Railroad Medicare Medicare	$16,847.37
Rate for Payer: UHC Dual Complete DSNP	$16,847.37
Rate for Payer: UHC Medicare Advantage	$16,847.37
Rate for Payer: VA VA	$16,847.37

MS-DRG 42.00: RECTAL RESECTION WITH MCC

Facility

$33,999.81

Service Code	MSDRG 332
Min. Negotiated Rate	$25,839.86
Max. Negotiated Rate	$33,999.81
Rate for Payer: Aetna Medicare	$28,287.84
Rate for Payer: Allen County Amish Medical Aid Commercial	$33,999.81
Rate for Payer: Amish Plain Church Group Commercial	$33,999.81
Rate for Payer: BCBS MAPPO	$27,199.85
Rate for Payer: BCN Medicare Advantage	$27,199.85
Rate for Payer: Health Alliance Plan Medicare Advantage	$27,199.85
Rate for Payer: Mclaren Medicare	$27,199.85
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$28,559.84
Rate for Payer: MI Amish Medical Board Commercial	$31,279.83
Rate for Payer: PACE Medicare	$25,839.86
Rate for Payer: PACE SWMI	$27,199.85
Rate for Payer: PHP Medicare Advantage	$27,199.85
Rate for Payer: Priority Health Medicare	$27,199.85
Rate for Payer: Railroad Medicare Medicare	$27,199.85
Rate for Payer: UHC Dual Complete DSNP	$27,199.85
Rate for Payer: UHC Medicare Advantage	$27,199.85
Rate for Payer: VA VA	$27,199.85

MS-DRG 42.00: RECTAL RESECTION WITHOUT CC/MCC

Facility

$16,563.65

Service Code	MSDRG 334
Min. Negotiated Rate	$12,588.37
Max. Negotiated Rate	$16,563.65
Rate for Payer: Aetna Medicare	$13,780.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,563.65
Rate for Payer: Amish Plain Church Group Commercial	$16,563.65
Rate for Payer: BCBS MAPPO	$13,250.92
Rate for Payer: BCN Medicare Advantage	$13,250.92
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,250.92
Rate for Payer: Mclaren Medicare	$13,250.92
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,913.47
Rate for Payer: MI Amish Medical Board Commercial	$15,238.56
Rate for Payer: PACE Medicare	$12,588.37
Rate for Payer: PACE SWMI	$13,250.92
Rate for Payer: PHP Medicare Advantage	$13,250.92
Rate for Payer: Priority Health Medicare	$13,250.92
Rate for Payer: Railroad Medicare Medicare	$13,250.92
Rate for Payer: UHC Dual Complete DSNP	$13,250.92
Rate for Payer: UHC Medicare Advantage	$13,250.92
Rate for Payer: VA VA	$13,250.92

MS-DRG 42.00: RED BLOOD CELL DISORDERS WITH MCC

Facility

$14,139.10

Service Code	MSDRG 811
Min. Negotiated Rate	$10,745.72
Max. Negotiated Rate	$14,139.10
Rate for Payer: Aetna Medicare	$11,763.73
Rate for Payer: Allen County Amish Medical Aid Commercial	$14,139.10
Rate for Payer: Amish Plain Church Group Commercial	$14,139.10
Rate for Payer: BCBS MAPPO	$11,311.28
Rate for Payer: BCN Medicare Advantage	$11,311.28
Rate for Payer: Health Alliance Plan Medicare Advantage	$11,311.28
Rate for Payer: Mclaren Medicare	$11,311.28
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$11,876.84
Rate for Payer: MI Amish Medical Board Commercial	$13,007.97
Rate for Payer: PACE Medicare	$10,745.72
Rate for Payer: PACE SWMI	$11,311.28
Rate for Payer: PHP Medicare Advantage	$11,311.28
Rate for Payer: Priority Health Medicare	$11,311.28
Rate for Payer: Railroad Medicare Medicare	$11,311.28
Rate for Payer: UHC Dual Complete DSNP	$11,311.28
Rate for Payer: UHC Medicare Advantage	$11,311.28
Rate for Payer: VA VA	$11,311.28

MS-DRG 42.00: RED BLOOD CELL DISORDERS WITHOUT MCC

Facility

$9,476.88

Service Code	MSDRG 812
Min. Negotiated Rate	$7,202.43
Max. Negotiated Rate	$9,476.88
Rate for Payer: Aetna Medicare	$7,884.76
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,476.88
Rate for Payer: Amish Plain Church Group Commercial	$9,476.88
Rate for Payer: BCBS MAPPO	$7,581.50
Rate for Payer: BCN Medicare Advantage	$7,581.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,581.50
Rate for Payer: Mclaren Medicare	$7,581.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,960.57
Rate for Payer: MI Amish Medical Board Commercial	$8,718.73
Rate for Payer: PACE Medicare	$7,202.43
Rate for Payer: PACE SWMI	$7,581.50
Rate for Payer: PHP Medicare Advantage	$7,581.50
Rate for Payer: Priority Health Medicare	$7,581.50
Rate for Payer: Railroad Medicare Medicare	$7,581.50
Rate for Payer: UHC Dual Complete DSNP	$7,581.50
Rate for Payer: UHC Medicare Advantage	$7,581.50
Rate for Payer: VA VA	$7,581.50

MS-DRG 42.00: REHABILITATION WITH CC/MCC

Facility

$15,291.16

Service Code	MSDRG 945
Min. Negotiated Rate	$11,621.28
Max. Negotiated Rate	$15,291.16
Rate for Payer: Aetna Medicare	$12,722.25
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,291.16
Rate for Payer: Amish Plain Church Group Commercial	$15,291.16
Rate for Payer: BCBS MAPPO	$12,232.93
Rate for Payer: BCN Medicare Advantage	$12,232.93
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,232.93
Rate for Payer: Mclaren Medicare	$12,232.93
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,844.58
Rate for Payer: MI Amish Medical Board Commercial	$14,067.87
Rate for Payer: PACE Medicare	$11,621.28
Rate for Payer: PACE SWMI	$12,232.93
Rate for Payer: PHP Medicare Advantage	$12,232.93
Rate for Payer: Priority Health Medicare	$12,232.93
Rate for Payer: Railroad Medicare Medicare	$12,232.93
Rate for Payer: UHC Dual Complete DSNP	$12,232.93
Rate for Payer: UHC Medicare Advantage	$12,232.93
Rate for Payer: VA VA	$12,232.93

MS-DRG 42.00: REHABILITATION WITHOUT CC/MCC

Facility

$11,341.76

Service Code	MSDRG 946
Min. Negotiated Rate	$8,619.74
Max. Negotiated Rate	$11,341.76
Rate for Payer: Aetna Medicare	$9,436.35
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,341.76
Rate for Payer: Amish Plain Church Group Commercial	$11,341.76
Rate for Payer: BCBS MAPPO	$9,073.41
Rate for Payer: BCN Medicare Advantage	$9,073.41
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,073.41
Rate for Payer: Mclaren Medicare	$9,073.41
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,527.08
Rate for Payer: MI Amish Medical Board Commercial	$10,434.42
Rate for Payer: PACE Medicare	$8,619.74
Rate for Payer: PACE SWMI	$9,073.41
Rate for Payer: PHP Medicare Advantage	$9,073.41
Rate for Payer: Priority Health Medicare	$9,073.41
Rate for Payer: Railroad Medicare Medicare	$9,073.41
Rate for Payer: UHC Dual Complete DSNP	$9,073.41
Rate for Payer: UHC Medicare Advantage	$9,073.41
Rate for Payer: VA VA	$9,073.41

MS-DRG 42.00: RENAL FAILURE WITH CC

Facility

$9,149.38

Service Code	MSDRG 683
Min. Negotiated Rate	$6,953.52
Max. Negotiated Rate	$9,149.38
Rate for Payer: Aetna Medicare	$7,612.28
Rate for Payer: Allen County Amish Medical Aid Commercial	$9,149.38
Rate for Payer: Amish Plain Church Group Commercial	$9,149.38
Rate for Payer: BCBS MAPPO	$7,319.50
Rate for Payer: BCN Medicare Advantage	$7,319.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$7,319.50
Rate for Payer: Mclaren Medicare	$7,319.50
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,685.48
Rate for Payer: MI Amish Medical Board Commercial	$8,417.42
Rate for Payer: PACE Medicare	$6,953.52
Rate for Payer: PACE SWMI	$7,319.50
Rate for Payer: PHP Medicare Advantage	$7,319.50
Rate for Payer: Priority Health Medicare	$7,319.50
Rate for Payer: Railroad Medicare Medicare	$7,319.50
Rate for Payer: UHC Dual Complete DSNP	$7,319.50
Rate for Payer: UHC Medicare Advantage	$7,319.50
Rate for Payer: VA VA	$7,319.50

MS-DRG 42.00: RENAL FAILURE WITH MCC

Facility

$15,054.20

Service Code	MSDRG 682
Min. Negotiated Rate	$11,441.19
Max. Negotiated Rate	$15,054.20
Rate for Payer: Aetna Medicare	$12,525.09
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,054.20
Rate for Payer: Amish Plain Church Group Commercial	$15,054.20
Rate for Payer: BCBS MAPPO	$12,043.36
Rate for Payer: BCN Medicare Advantage	$12,043.36
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,043.36
Rate for Payer: Mclaren Medicare	$12,043.36
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,645.53
Rate for Payer: MI Amish Medical Board Commercial	$13,849.86
Rate for Payer: PACE Medicare	$11,441.19
Rate for Payer: PACE SWMI	$12,043.36
Rate for Payer: PHP Medicare Advantage	$12,043.36
Rate for Payer: Priority Health Medicare	$12,043.36
Rate for Payer: Railroad Medicare Medicare	$12,043.36
Rate for Payer: UHC Dual Complete DSNP	$12,043.36
Rate for Payer: UHC Medicare Advantage	$12,043.36
Rate for Payer: VA VA	$12,043.36

MS-DRG 42.00: RENAL FAILURE WITHOUT CC/MCC

Facility

$6,437.75

Service Code	MSDRG 684
Min. Negotiated Rate	$4,892.69
Max. Negotiated Rate	$6,437.75
Rate for Payer: Aetna Medicare	$5,356.21
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,437.75
Rate for Payer: Amish Plain Church Group Commercial	$6,437.75
Rate for Payer: BCBS MAPPO	$5,150.20
Rate for Payer: BCN Medicare Advantage	$5,150.20
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,150.20
Rate for Payer: Mclaren Medicare	$5,150.20
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5,407.71
Rate for Payer: MI Amish Medical Board Commercial	$5,922.73
Rate for Payer: PACE Medicare	$4,892.69
Rate for Payer: PACE SWMI	$5,150.20
Rate for Payer: PHP Medicare Advantage	$5,150.20
Rate for Payer: Priority Health Medicare	$5,150.20
Rate for Payer: Railroad Medicare Medicare	$5,150.20
Rate for Payer: UHC Dual Complete DSNP	$5,150.20
Rate for Payer: UHC Medicare Advantage	$5,150.20
Rate for Payer: VA VA	$5,150.20

MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC

Facility

$10,143.44

Service Code	MSDRG 178
Min. Negotiated Rate	$7,709.01
Max. Negotiated Rate	$10,143.44
Rate for Payer: Aetna Medicare	$8,439.34
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,143.44
Rate for Payer: Amish Plain Church Group Commercial	$10,143.44
Rate for Payer: BCBS MAPPO	$8,114.75
Rate for Payer: BCN Medicare Advantage	$8,114.75
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,114.75
Rate for Payer: Mclaren Medicare	$8,114.75
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,520.49
Rate for Payer: MI Amish Medical Board Commercial	$9,331.96
Rate for Payer: PACE Medicare	$7,709.01
Rate for Payer: PACE SWMI	$8,114.75
Rate for Payer: PHP Medicare Advantage	$8,114.75
Rate for Payer: Priority Health Medicare	$8,114.75
Rate for Payer: Railroad Medicare Medicare	$8,114.75
Rate for Payer: UHC Dual Complete DSNP	$8,114.75
Rate for Payer: UHC Medicare Advantage	$8,114.75
Rate for Payer: VA VA	$8,114.75

MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC

Facility

$16,158.14

Service Code	MSDRG 177
Min. Negotiated Rate	$12,280.18
Max. Negotiated Rate	$16,158.14
Rate for Payer: Aetna Medicare	$13,443.57
Rate for Payer: Allen County Amish Medical Aid Commercial	$16,158.14
Rate for Payer: Amish Plain Church Group Commercial	$16,158.14
Rate for Payer: BCBS MAPPO	$12,926.51
Rate for Payer: BCN Medicare Advantage	$12,926.51
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,926.51
Rate for Payer: Mclaren Medicare	$12,926.51
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$13,572.84
Rate for Payer: MI Amish Medical Board Commercial	$14,865.49
Rate for Payer: PACE Medicare	$12,280.18
Rate for Payer: PACE SWMI	$12,926.51
Rate for Payer: PHP Medicare Advantage	$12,926.51
Rate for Payer: Priority Health Medicare	$12,926.51
Rate for Payer: Railroad Medicare Medicare	$12,926.51
Rate for Payer: UHC Dual Complete DSNP	$12,926.51
Rate for Payer: UHC Medicare Advantage	$12,926.51
Rate for Payer: VA VA	$12,926.51

MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC

Facility

$8,001.15

Service Code	MSDRG 179
Min. Negotiated Rate	$6,080.87
Max. Negotiated Rate	$8,001.15
Rate for Payer: Aetna Medicare	$6,656.96
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,001.15
Rate for Payer: Amish Plain Church Group Commercial	$8,001.15
Rate for Payer: BCBS MAPPO	$6,400.92
Rate for Payer: BCN Medicare Advantage	$6,400.92
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,400.92
Rate for Payer: Mclaren Medicare	$6,400.92
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$6,720.97
Rate for Payer: MI Amish Medical Board Commercial	$7,361.06
Rate for Payer: PACE Medicare	$6,080.87
Rate for Payer: PACE SWMI	$6,400.92
Rate for Payer: PHP Medicare Advantage	$6,400.92
Rate for Payer: Priority Health Medicare	$6,400.92
Rate for Payer: Railroad Medicare Medicare	$6,400.92
Rate for Payer: UHC Dual Complete DSNP	$6,400.92
Rate for Payer: UHC Medicare Advantage	$6,400.92
Rate for Payer: VA VA	$6,400.92

MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH CC

Facility

$11,282.05

Service Code	MSDRG 181
Min. Negotiated Rate	$8,574.36
Max. Negotiated Rate	$11,282.05
Rate for Payer: Aetna Medicare	$9,386.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,282.05
Rate for Payer: Amish Plain Church Group Commercial	$11,282.05
Rate for Payer: BCBS MAPPO	$9,025.64
Rate for Payer: BCN Medicare Advantage	$9,025.64
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,025.64
Rate for Payer: Mclaren Medicare	$9,025.64
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,476.92
Rate for Payer: MI Amish Medical Board Commercial	$10,379.49
Rate for Payer: PACE Medicare	$8,574.36
Rate for Payer: PACE SWMI	$9,025.64
Rate for Payer: PHP Medicare Advantage	$9,025.64
Rate for Payer: Priority Health Medicare	$9,025.64
Rate for Payer: Railroad Medicare Medicare	$9,025.64
Rate for Payer: UHC Dual Complete DSNP	$9,025.64
Rate for Payer: UHC Medicare Advantage	$9,025.64
Rate for Payer: VA VA	$9,025.64

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